The invention relates generally to devices and methods to promote guided bone and tissue healing after occurrence of an inflammatory traumatic or surgical wound. More specifically, the invention relates to the guided healing of a bony deficit of the maxillae or mandible after extraction of an impacted molar tooth or after periodontal surgery, or after fracture repair, or jaw surgery for any reason.
Normally, when a patient's wisdom tooth or molar is removed or when the above surgeries are performed, a surgeon incises a flap of soft tissue in back of, or posterior to, an adjacent tooth so as to visualize the impacted tooth or surgical field. This operation is routine. Sometimes the bone in the field is absent or unhealthy. This problem may be present before the operation or after the surgery is completed. For example, pre-operatively the bone may have begun a resorptive process due to the inflammation or tumor around an impacted third molar or other described injury or deficit.
The oral surgeon attempts to suture the incised tissue flap back together, creating an environment for bone healing. If the bone does not heal properly and regenerate, then the patient may develop a periodontal pocket or an open space in back of the surgerized area. Because this area tends to retain trapped food or become infected, it rarely heals well. Poor bone healing in this circumstance is more prevalent in the older population, but can also occur in young patients.
The dental profession has some experience with a technique called "Tissue Guided Regeneration" or TGR. When the bone does not heal well, i.e., up to its proper level, one factor is the need to protect the proper environment required by the precursor bone cells, called progenitor cells, to form new bone. These multipotential bone cells which form new bone are undifferentiated and demand a specific type of biological medium to form mature bone. This process may take about one or two months. When a surgeon closes a wound, the epithelium in that wound invaginates or creeps into the field that has been created by removing the tooth or performing surgery. The invagination process is very fast, usually taking 7-14 days. Once invagination of epithelium occurs, it is impossible for the progenitor bone cells to occupy this location to create new bone. Thus, the bone healing is compromised, and the level of potential bone growth is not achieved.